People who have lost their health coverage since the beginning of the year now have a streamlined pathway to sign up for Obamacare.
The Department of Health and Human Services recently changed a question on the application for Affordable Care Act insurance to indicate that losing coverage since the start of the year allows people to sign up outside of the normal open enrollment period, according to people following ACA coverage.
Previously, the application for such coverage on the federal HealthCare.gov website used in 38 states asked if people had lost their coverage in the last 60 days—and the agency hasn’t made any announcement of the change.
The change reopens the door to Obamacare to many people who didn’t sign up within 60 days because they thought they would be back at work before then. It also eliminates some of the hoops people have to jump through in signing up for coverage.
“It’s a really important step for people who have lost job-based coverage,” Tara Straw, senior health policy analyst for the Center on Budget and Policy Priorities, said in an interview. “Many more people will be able to get it automatically.”
However, it doesn’t allow people who were uninsured before the pandemic to get coverage—as congressional Democrats have called for and as 12 of the exchanges run by states have done.
The Urban Institute estimates that on an average monthly basis during the pandemic period, 3.5 million people will have lost employer-sponsored insurance coverage and become uninsured.
Nearly 500,000 people had signed up for coverage on HealthCare.gov due to job loss through June.
The HHS didn’t have an immediate response to a request for comment.
The HHS’s Center for Consumer Information and Insurance Oversight, which operates HealthCare.gov, based its change on regulatory guidance the Trump administration issued in 2018, allowing for special enrollment periods when the Federal Emergency Management Agency declares a disaster, Straw said.
FEMA declared a nationwide disaster due to the Covid-19 pandemic in January. The provision extends until 60 days after the end of the FEMA incident period, Straw said.
The FEMA special enrollment period, or SEP, isn’t specific to Covid, Straw said. “If there’s a FEMA-declared disaster, then there’s an extension on your ability to enroll” as long as enrollees qualify due to life changes such as loss of coverage, moving, or having a baby, she said.
However, the administration hasn’t publicized it, and Affordable Care Act advocates only recently noticed the change on HealthCare.gov.
The FEMA special enrollment period will allow people who have lost coverage in 2020 to enroll more easily, but they still have to provide documentation that they lost coverage, Straw said.
Previously, “no one knew about it, and it was a very complicated process to get it,” requiring contacting offices of the Centers for Medicare & Medicaid Services, she said.
“This is a really big deal,” Shelli Quenga, director of programs for the Palmetto Project, a nonprofit health insurance broker that serves South Carolina, said in an interview.
“We are talking to people now who are saying, I thought I was going to get called back on my job, I thought I was going to start working again, and I haven’t been called back. I don’t have health insurance. It’s been more than 60 days,” Quenga said.
An estimated 20% of South Carolinians, about 1 million people, are uninsured as a result of the pandemic, Quenga said. “We should be able to get a lot more people enrolled in coverage,” she said.
But, she added, “The challenge now is to get the word out because HealthCare.gov isn’t doing that.”